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目的比较国际糖尿病联盟(IDF)、美国国家胆固醇教育计划(NCEP)成人治疗组第三次报告[ATPⅢ(修订)]和中华医学会糖尿病学分会(CDS)3种代谢综合征(MS)诊断标准在北京市部分社区中老年人群中应用的异同。方法采用心血管疾病危险因素调查的资料,共计4 628人,分别应用 IDF、ATPⅢ(修订)和 CDS 标准诊断 MS,并比较 MS 的患病率及诊断的一致性。结果IDF、ATPⅢ(修订)和 CDS 标准诊断 MS 的患病率分别为40.3%、44.3%和35.7%。IDF 与 CDS、ATPⅢ(修订)与 CDS、IDF 与 ATPⅢ(修订)分别同时诊断81.9%、83.7%和96.0%的个体为 MS 或非 MS者。ATPⅢ(修订)标准诊断为 MS 的患者中有4.0%无中心性肥胖,即不能被 IDF 诊断为MS。ATPⅢ标准诊断腹型肥胖的患病率仅为19.6%,明显低于 CDS 和 IDF 标准的检出率,进行修订后 ATPⅢ标准诊断腹型肥胖的患病率为58.6%,与 CDS 标准诊断一致性较好,二者诊断的符合率为80.6%。结论 IDF、ATPⅢ(修订)及 CDS 标准对于北京市社区人群 MS 诊断的一致性较好,3种 MS 的诊断标准均可用于中国人群。
Objective To compare the diagnostic criteria of the three metabolic syndrome (MS) diagnostic criteria of the International Diabetes Federation (IDF), the Third Report of the National Cholesterol Education Program (NCEP) Adult Treatment Group [ATPIII (Revised)] and the Chinese Medical Association Diabetes Branch (CDS) Similarities and Differences Applied in Middle-aged and Elderly Population in Some Communities in Beijing. Methods A total of 4 628 individuals were surveyed according to the risk factors for cardiovascular diseases. IDF, ATP Ⅲ (revised) and CDS were used to diagnose MS, and the prevalence and diagnostic consistency of MS were compared. Results The prevalence rates of IDF, ATPⅢ (revised) and CDS standard diagnosis MS were 40.3%, 44.3% and 35.7% respectively. IDF and CDS, ATPⅢ (revised) and CDS, IDF and ATPⅢ (revised) respectively diagnosed 81.9%, 83.7% and 96.0% of individuals as MS or non-MS. 4.0% of patients diagnosed with MS in the ATP III (revised) standard had no central obesity, ie can not be diagnosed with MS by IDF. The prevalence of abdominal obesity diagnosed by ATP Ⅲ standard was only 19.6%, which was significantly lower than that of CDS and IDF. The prevalence of abdominal obesity diagnosed by revised ATP Ⅲ standard was 58.6%, consistent with the standard diagnostic CDS Better, the two diagnostic coincidence rate of 80.6%. Conclusion IDF, ATP Ⅲ (revised) and CDS standards are of good consistency for MS diagnosis in Beijing community population. The diagnostic criteria of three kinds of MS can be used in Chinese population.